title: GERD related micro-aspiration in chronic mustard-induced pulmonary disorder.
abstract: OBJECTIVE
  Bronchiolitis obliterans (BO) is the main pulmonary involvement resulting from sulfur mustard (SM) gas exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate the prevalence of gastro-esophageal reflux (GER) and gastric micro-aspiration in SM gas injured patients with chronic pulmonary diseases and recurrent episodes of exacerbations.
  
  
  METHODS
  This cross-sectional study was done at Baqiyatallah University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid.
  
  
  RESULTS
  Our result showed that bile acids were found to be high in 21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected in BAL fluid of all patients.
  
  
  CONCLUSIONS
  Most of BO patients after exposure to SM suffer GER, while none the etiologic factors of GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism regarding GER and BO and treatment.
authors.affiliation: Respiratory Diseases and TB Research Center of Guilan University of Medical Science, Razi Hospital, Rasht, Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Aliannejad
authors.forename: Seyed-Mehdi
authors.initials: SM
authors.lastname: Hashemi-Bajgani
authors.forename: Asharaf
authors.initials: A
authors.lastname: Karbasi
authors.forename: Mahvash
authors.initials: M
authors.lastname: Jafari
authors.forename: Jafar
authors.initials: J
authors.lastname: Aslani
authors.forename: Maryam
authors.initials: M
authors.lastname: Salehi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ghanei
keywords: Bronchiolitis obliterans; gastro-esophageal reflux; sulfur mustard